SHORT AND LONG TERM OUTCOMES OF A … - Purdy.pdf · BRIDGING RPN-BScN PROGRAM:PROGRAM PRELIMINARY...
Transcript of SHORT AND LONG TERM OUTCOMES OF A … - Purdy.pdf · BRIDGING RPN-BScN PROGRAM:PROGRAM PRELIMINARY...
SHORT AND LONG TERM SHORT AND LONG TERM OUTCOMES OF A OUTCOMES OF A BRIDGING RPNBRIDGING RPN--BScNBScN PROGRAMPROGRAM:PRELIMINARY RESULTS
RPNAO 54th AGM & Conference
Nancy Purdy, RN, PhD1; Murphy, S., RN, PhD2, Elaine Santa Mina, RN, PhD1, Paula Mastrilli, RN, PhD(c) 1, Kileen Tucker-Scott, RN, PhD1, Lynda Atack, RN, PhD2, Ellen Bull, RN, MAEd2, Victoria Reid-de Jong, RN, MS2, Jasmine Badhan, RN, MScN2.1 Daphne Cockwell School of Nursing, Ryerson University, 2 Centennial College
Background
Ongoing nursing shortage (Canada) Projected shortage - 60,000 full-time equivalent RNs by 2022 Practical Nurses (LPN/RPN) comprise 22.9% of the total regulated nursing workforce in 2010 30,423 RPNs in Ontario (2010)
Support career mobility for Registered Practical Nurses (RPNs)
College-university partnership to enhance access to RN degree education for RPNs in practice in both urban and non-urban areas 6 post-diploma programs in Ontario
1. Centennial – Ryerson2. Mohawk, Conestoga – McMaster3. Algonquin – Ottawa4. Durham, Georgian – UOIT5. Canadore, George Brown – Nipissing6. Fleming - Trent
Study Purpose
To evaluate the short and long term outcomes of two new program delivery options for bridging and post-diploma degree completion programs including post-graduation follow-up.
part-time RAC hybrid versus on-campus flex and full time delivery options -CC Bridging
part-time versus full-time on-campus delivery options RU- post diploma degree completion
long term program outcomes of the CC-RU academic pathway from diploma RPN to BScN
Research Questions
A. Unique challenges and success strategiesmotivation to return to schoolchallenges success strategies
B. Differences in outcomes betweenBridging program: Part time study (RACs) vs. Full time study, On campusDegree completion program: Full Time vs. Part Time study
C. Post-graduation BScN student outcomes
Design and Methods
Mixed methods descriptive comparative design Survey/interviews first and final terms Student cohorts beginning Fall 2009 and 2010
(50-90 students per class)
Response rates 4-70% across cohorts
Outcome Measures – What does program effectiveness mean?
SHORT term outcomes
Academic success (GPA, academic standing)
Student engagement
Satisfaction with learning experience National Survey of Student Engagement© (NSSE): he College Student Report, Indiana University
Professional socialization: Nursing Professional Values Scale-Revised (NPVS-R) (Weis & Schank, 2000).
LONG term outcomes
Success with registration exams
Employment characteristics
Transition to RN role: Casey-Fink Graduate Nurse Experience Survey (Casey, Fink, Krugman & Propst, 2004)
Unique Challenges and Successes
Motivation
• wanted leadership role and to think more critically about patients• “not get overlooked”• wider scope, limited role as an RPN• broader job and career opportunities (better pay)• “could be a better nurse if I have more knowledge”
Unique Challenges and Successes
Challenges
Group work e.g. students living far apart, grading schemes
Time management i.e. balancing work, school and family
Accessing resources from off campus
Challenges
Group work e.g. students living far apart, grading schemes
Time management i.e. balancing work, school and family
Accessing resources from off campus
Success strategies
Good organizational skills, making school a priority
Reduce work hours Partnering with other
students Read regularly
Success strategies
Good organizational skills, making school a priority
Reduce work hours Partnering with other
students Read regularly
Centennial Bridging Program – SHORT TERM OUTCOMES
Grades – T1 – RAC 2.97
Academic standing – T1 -97% clear, 3% on probation
Other data in progress
BRIDGING Program - Student Engagement
*significant differences between RAC students and on campus students (p<.05)
Scale: 1 (never) 2 (sometimes) 3 (often) 4 (very often)
BRIDGING Program - Satisfaction with overall learning experience
1 (poor) 2 (fair) 3 (good) 4 (excellent)
1 (definitely no) 2 (probably no) 3 (probably yes) 4 (definitely yes)
DEGREE COMPLETION Program - Student Engagement
Scale: 1 (never) 2 (sometimes) 3 (often) 4 (very often)
DEGREE COMPLETION Program –Satisfaction with overall learning experience
1 (poor) 2 (fair) 3 (good) 4 (excellent)
1 (definitely no) 2 (probably no) 3 (probably yes) 4 (definitelyyes)\\
Demand and attrition rates
DEMAND 2007-2010 – exceeded targets
2011 – decreased – policy changes, launch of RACs
Full time demand greatest
ATTRITION Time to completion – RU 20-25% out of phase
General Comments
Can’t wait to finish my BScN!!! This program has allowed me to
continue working while completing my degree which is
great! I found the program kind of heavy and needed to study and read content constantly from course and outside.
I found the program kind of heavy and needed to study and read content constantly from course and outside.
Amazing support from professors, very well structured program, amazing experience.
Amazing support from professors, very well structured program, amazing experience.
LONG Term Outcomes n=35/115 (30%)
Licensing Exam
Pass on first attempt 94%Employment (6-12 months post-graduation)
Full time 56*Multiple employers 44%Employed as : RN
RPN94%36%
Same employer as a student 64%Setting: Acute care
LTC61%14%
Job title: Staff nurseManager
94%3%
Location - GTA 75%
Transition to RN Role
How has your practice changed as a result of your experiences in the post-diploma program at RU?
Scale Range 1-5
(mean)
Critical appraisal of the literature 4.36Self-confidence 4.0Leadership skills and abilities 4.0Interpersonal skills 3.8Ability to work independently 3.78Work collaboratively with others 3.69Decision-making abilities 4.14Critical thinking 4.25Demonstrate caring 2.83Appreciation of issues related to advocacy 3.83Reflective practice 3.86
Transition to RN Role
Comfort/confidence performing skills and procedures:Agree/
Strongly Agree(%)
Confident communicating with physicians 94Comfortable caring for unstable clients/unpredictable outcomes 90Comfortable delegating tasks to RPN 84No difficulty prioritizing patient needs 94Able to complete assignment on time 91Expectations of me in this job are realistic 76Feel prepared to complete my job responsibilities 91No difficulty organizing patient care needs 94Feel I will not harm a patient due to my knowledge and
experience88
Transition to RN Role
Difficulties experienced with the transition from student to BScN-RN role? (%)Role expectations (e.g. autonomy, more responsibility, being a preceptor or in-charge)
44
Lack confidence (e.g. communication skills with MD, delegation, knowledge deficit, critical
thinking)
19
Workload(e.g. organizing, prioritizing, feeling overwhelmed, nurse-patient ratios, patient
acuity)
31
Fears(e.g. patient safety)
14
Orientation issues(e.g. unit familiarization, learning technology, relationship with multiple
preceptors, information overload)
36
Transition to RN Role
Aspects of work environment that are most satisfying (%)
Peer support(e.g. belonging, team approach, helpful and friendly staff)
61
Patient and families(e.g. making a difference, positive feedback, patient satisfaction, patient
interaction)
61
Ongoing learning(e.g. preceptors, unit role models, mentorship)
50
Professional nursing role(e.g. challenge, benefits, fast pace, critical thinking, empowerment)
53
Positive work environment(e.g. good nurse:patient ratios, available resources, great facility, up-to-date
technology)
31
Future Educational Plans(%)
Return to university 66%Currently applying or are enrolled in further education (n=16) 44%
Type of program:Clinical specializationMasters degreeNurse PractitionerManagement
36%22%8%2%
Main reasonCareer advancement/goalsEmployment/job securityKnowledge development/specialize
19%19%36%
Overall Views
Overall, how well did CC and RU prepare you for: Good – Excellent(%)
Employment as a RN in your current role 72Further education 83Overall satisfaction with the program at RU (%)
1=Not at all 62 113=Somewhat 174 255=A great deal 42
General Comments
Satisfied with program Amazing support, amazing experience Proud to be a Ryerson graduate
Clinical placement issues (provincial issue) Lack of choice Placements not critical enough, hindered job prospects Feel unprepared to work in a hospital, need more acute clinical practice hours
Coursework Too many papers Less self-learning Too difficult, set you up for failure
Conclusions
Adjustment to student role similar for all students Challenged by competing priorities: school, work, family Success enhanced by time management
Few significant differences Between distance and on-campus delivery with the exception of student interaction, active learning and academic challenge for RAC students (lower scores)
Between part-time and full-time delivery (tentative)
Programs prepare students for employment and transition to RN role Centennial-Ryerson program offers a feasible ‘academic pathway’to prepare nurses i.e. varying entry points into nursing education
Strategies to Support Student Success
Before and during programBefore and during program
•Resources for on-campus and distance students•Pre-workshop (online) e.g. Literature search skills, learning management system, APA referencing•Academic supports e.g. Writing and Learning Centre •Non-academic supports e.g. time management•Academic advisors
Individual actionsIndividual actions
•Decrease work hours•Support from fellow students•Enroll in one course (elective) to orient yourself to universityexpectations
FOR MORE INFORMATION, CONTACT
Centennial College PRN-BScN Bridging Full-time: http://www.centennialcollege.ca/Programs/ProgramOverview.aspx?Program=9251
Part-time Hybrid: http://db2.centennialcollege.ca/ce/certdetail.php?CertificateCode=7993
Part-time Application Forms: http://www.centennialcollege.ca/parttime/RPN%20Hybrid%20Application%20Form/
Research – Nancy Purdy, [email protected]
Bridging Program - Victoria Reid-de-Jong, [email protected] Ellen Bull, [email protected]
Post-diploma BScN - Paula Mastrilli, [email protected] Elaine Santamina, [email protected]